ID
6485
Beschrijving
CALGB: 80802 Treatment Form Sorafenib Tosylate With or Without Doxorubicin Hydrochloride in Treating Patients With Locally Advanced or Metastatic Liver Cancer NCT01015833 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=741A6270-CE1B-C531-E040-BB89AD431F2C
Link
Trefwoorden
Versies (2)
- 19-09-12 19-09-12 -
- 03-01-15 03-01-15 - Martin Dugas
Geüploaded op
3 januari 2015
DOI
Voor een aanvraag inloggen.
Licentie
Creative Commons BY-NC 3.0 Legacy
Model Commentaren :
Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.
Itemgroep Commentaren voor :
Item Commentaren voor :
U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.
Treatment Form Liver Cancer CALGB 80802
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
Beschrijving
Treatment Data
Beschrijving
Cycle Number
Datatype
integer
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25379
Beschrijving
Body Surface Area
Datatype
float
Maateenheden
- m2
Alias
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property
- C25157
- UMLS CUI-1
- C0005902
Beschrijving
Doxorubicin dose received this cycle
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C456
- UMLS CUI-1
- C0013089
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS CUI-2
- C0178602
- NCI Thesaurus Property
- C25379
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25488
Beschrijving
Agent dose administered
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C0678766
- NCI Thesaurus Property
- C25616
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property-2
- C25375
- NCI Thesaurus Property-3
- C25431
- NCI Thesaurus Property-4
- C25256
- NCI Thesaurus ValueDomain
- C25488
Beschrijving
Drug administration method
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C0449311
- NCI Metathesaurus ObjectClass
- CL111054
- NCI Thesaurus Property
- C25409
Beschrijving
Doxorubicin dose reduced this cycle
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C456
- UMLS CUI-1
- C0013089
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS CUI-2
- C1707814
- NCI Thesaurus Property
- C25640
- NCI Thesaurus Property-2
- C25472
- NCI Thesaurus Property-3
- C25256
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus ValueDomain-2
- C25488
Beschrijving
Sorafenib dose received this cycle
Datatype
float
Alias
- NCI Thesaurus ValueDomain
- C25304
- UMLS CUI-1
- C1516119
- NCI Thesaurus Property
- C25379
- UMLS CUI-2
- C0178602
- NCI Thesaurus ValueDomain-2
- C25488
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ObjectClass-2
- C61948
Beschrijving
Sorafenib dose reduced
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C1516119
- NCI Thesaurus ObjectClass-2
- C61948
- UMLS CUI-2
- C1707814
- NCI Thesaurus Property
- C25640
- NCI Thesaurus Property-2
- C25472
- NCI Thesaurus Property-3
- C25256
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus ValueDomain-2
- C25488
Beschrijving
SorafenibAgentCycleMissingDoseIndicator
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ObjectClass-2
- C61948
- NCI Thesaurus Property
- C54031
- NCI Thesaurus Property-2
- C25472
- NCI Thesaurus Property-3
- C25256
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus ValueDomain-2
- C25488
- UMLS CUI-1
- C1516119
- UMLS CUI-2
- C1709043
Beschrijving
SorafenibAgentNotAdministeredTotalDoseCount
Datatype
integer
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ObjectClass-2
- C61948
- NCI Thesaurus Property
- C25594
- NCI Thesaurus Property-2
- C25382
- NCI Thesaurus ValueDomain
- C25463
- UMLS CUI-1
- C1516119
- UMLS CUI-2
- C0750480
- UMLS CUI-3
- C1709043
Beschrijving
G-CSF or GM-CSF
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0796404
- NCI Thesaurus ObjectClass
- C20586
- NCI Thesaurus Property
- C25340
Beschrijving
G-CSF or GM-CSF start date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0796404
- NCI Thesaurus ObjectClass
- C20586
- UMLS CUI-2
- C0808070
- NCI Thesaurus Property
- C25340
Beschrijving
Protocol Deviation Description
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C1705236
- NCI Thesaurus ObjectClass
- C50996
- NCI Thesaurus Property
- C25365
Beschrijving
Supportive Care non-Protocol
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0344211
- NCI Thesaurus Property
- C15368
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-2
- C1518384
- NCI Thesaurus ObjectClass-2
- C37902
Beschrijving
Supportive Care non-Protocol, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0344211
- NCI Thesaurus Property
- C15368
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-2
- C1518384
- NCI Thesaurus ObjectClass-2
- C37902
- UMLS CUI-3
- C1521902
Beschrijving
Off Treatment Reason
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
Beschrijving
Off Treatment Reason, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
- UMLS CUI-3
- C1521902
Beschrijving
Alternative therapy, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0949216
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25415
- NCI Thesaurus Property
- C25382
Similar models
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property-2)
C1265611 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
C1302181 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C0806020 (UMLS CUI-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property-2)
C0205313 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C2045829 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C25712 (NCI Thesaurus ValueDomain)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS CUI-1)
C0013089 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C0178602 (UMLS CUI-2)
C25379 (NCI Thesaurus Property)
C25304 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C0678766 (UMLS CUI-1)
C25616 (NCI Thesaurus Property)
C1521801 (UMLS CUI-2)
C25375 (NCI Thesaurus Property-2)
C25431 (NCI Thesaurus Property-3)
C25256 (NCI Thesaurus Property-4)
C25488 (NCI Thesaurus ValueDomain)
C0449311 (UMLS CUI-1)
CL111054 (NCI Metathesaurus ObjectClass)
C25409 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA)
C0013089 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C1707814 (UMLS CUI-2)
C25640 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C25256 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C1516119 (UMLS CUI-1)
C25379 (NCI Thesaurus Property)
C0178602 (UMLS CUI-2)
C25488 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus ObjectClass)
C61948 (NCI Thesaurus ObjectClass-2)
C1516119 (UMLS CUI-1)
C61948 (NCI Thesaurus ObjectClass-2)
C1707814 (UMLS CUI-2)
C25640 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C25256 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C61948 (NCI Thesaurus ObjectClass-2)
C54031 (NCI Thesaurus Property)
C25472 (NCI Thesaurus Property-2)
C25256 (NCI Thesaurus Property-3)
C25180 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1516119 (UMLS CUI-1)
C1709043 (UMLS CUI-2)
C1298908 (UMLS 2011AA)
C61948 (NCI Thesaurus ObjectClass-2)
C25594 (NCI Thesaurus Property)
C25382 (NCI Thesaurus Property-2)
C25463 (NCI Thesaurus ValueDomain)
C1516119 (UMLS CUI-1)
C0750480 (UMLS CUI-2)
C1709043 (UMLS CUI-3)
C0796404 (UMLS CUI-1)
C20586 (NCI Thesaurus ObjectClass)
C25340 (NCI Thesaurus Property)
C0796404 (UMLS CUI-1)
C20586 (NCI Thesaurus ObjectClass)
C0808070 (UMLS CUI-2)
C25340 (NCI Thesaurus Property)
C1705236 (UMLS CUI-1)
C50996 (NCI Thesaurus ObjectClass)
C25365 (NCI Thesaurus Property)
C0344211 (UMLS CUI-1)
C15368 (NCI Thesaurus Property)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS CUI-2)
C37902 (NCI Thesaurus ObjectClass-2)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0344211 (UMLS CUI-1)
C15368 (NCI Thesaurus Property)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS CUI-2)
C37902 (NCI Thesaurus ObjectClass-2)
C1521902 (UMLS CUI-3)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C1521902 (UMLS CUI-3)
C0949216 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25415 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)